The relationship between childhood adversity and sleep quality among rural older adults in China: the mediating role of anxiety and negative coping.

BACKGROUND: Studies have revealed the effects of childhood adversity, anxiety, and negative coping on sleep quality in older adults, but few studies have focused on the association between childhood adversity and sleep quality in rural older adults and the potential mechanisms of this influence. In this study, we aim to evaluate sleep quality in rural older adults, analyze the impact of adverse early experiences on their sleep quality, and explore whether anxiety and negative coping mediate this relationship. METHODS: Data were derived from a large cross-sectional study conducted in Deyang City, China, which recruited 6,318 people aged 65 years and older. After excluding non-agricultural household registration and lack of key information, a total of 3,873 rural older adults were included in the analysis. Structural equation modelling (SEM) was used to analyze the relationship between childhood adversity and sleep quality, and the mediating role of anxiety and negative coping. RESULTS: Approximately 48.15% of rural older adults had poor sleep quality, and older adults who were women, less educated, widowed, or living alone or had chronic illnesses had poorer sleep quality. Through structural equation model fitting, the total effect value of childhood adversity on sleep quality was 0.208 (95% CI: 0.146, 0.270), with a direct effect value of 0.066 (95% CI: 0.006, 0.130), accounting for 31.73% of the total effect; the total indirect effect value was 0.142 (95% CI: 0.119, 0.170), accounting for 68.27% of the total effect. The mediating effects of childhood adversity on sleep quality through anxiety and negative coping were significant, with effect values of 0.096 (95% CI: 0.078, 0.119) and 0.024 (95% CI: 0.014, 0.037), respectively. The chain mediating effect of anxiety and negative coping between childhood adversity and sleep quality was also significant, with an effect value of 0.022 (95% CI: 0.017, 0.028). CONCLUSIONS: Anxiety and negative coping were important mediating factors for rural older adult's childhood adversity and sleep quality. This suggests that managing anxiety and negative coping in older adults may mitigate the negative effects of childhood adversity on sleep quality.

A nanoengineered vanadium oxide composite as a high-performance anode for aqueous Li-ion hybrid batteries.

Aqueous lithium-ion batteries (LIBs) have received increasing attention as a promising solution for stationary energy storage systems due to their low environmental impact, non-flammability and low cost. Despite recent progress in electrolyte development and cathode manufacturing, the lack of anode materials with high specific capacity presents difficult challenges for a wide range of applications. In this study, we propose a novel synthetic strategy to fabricate a pseudocapacitive V2O5/graphene composite as a highly functional anode material for aqueous LIBs. The designed synthesis combines a fast laser-scribing step with controlled calcination to tune the morphology and oxidation state of the electrochemically active vanadium oxide species while obtaining a highly conductive graphene scaffold. The optimized V2O5/graphene anode shows an outstanding specific capacity of 158 mA h g-1 in three-electrode measurements. When the V2O5/graphene anode is paired with an LiMn2O4 cathode, the charge storage mechanism of the full cell is revealed to be dominantly surface-controlled, resulting in remarkable rate performance. Specifically, the full cell can reach a specific capacity of 151 and 107 mA h (g anode)-1 at C/6 and 3C, respectively. Moreover, this hybrid battery can achieve a high power density and an energy density of 650 W kg-1 at 15.6 W h kg-1 and 81.5 W h kg-1 at 13.6 W kg-1, respectively, outperforming most aqueous LIBs reported in the literature. This innovative strategy provides a pathway to incorporate pseudocapacitive electrodes for improving aqueous lithium-ion storage systems, enabling safe operation of large-scale energy storage without compromising their electrochemical performance.

Impact of dry eye disease treatment on patient quality of life.

Dry eye disease (DED) is a common multifactorial disease affecting a substantial proportion of the population worldwide. Objective tests and subjective symptoms evaluation are necessary to assess DED. Although various treatments have been introduced, accurately evaluating the efficacy of those treatments is difficult because of the disparity between diagnostic tests and patient-reported symptoms. We reviewed the questionnaires used to evaluate DED and the improvements of quality of life with various treatments. In addition, we highlighted the importance of patient-reported outcomes (PRO) assessments for evaluating the effect of DED treatments. Given that the assessment of DED treatment effectiveness substantially relies on individual ocular experiences, acquiring qualitative PRO data is essential for comprehensive evaluation and optimal treatment management. Clinicians should not only focus on improving objective symptoms but also prioritize the well-being of patients in clinical management.

Reprecipitation: A Rapid Synthesis of Micro-Sized Silicon-Graphene Composites for Long-lasting Lithium-Ion Batteries.

Silicon microparticles (SiMPs) have gained significant attention as a lithium-ion battery anode material due to their 10 times higher theoretical capacity compared to conventional graphite anodes as well as their much lower production cost than silicon nanoparticles (SiNPs). However, SiMPs have suffered from poorer cycle life relative to SiNPs because their larger size makes them more susceptible to volume changes during charging and discharging. Creating a wrapping structure in which SiMPs are enveloped by carbon layers has proven to be an effective strategy to significantly improve the cycling performance of SiMPs. However, the synthesis processes are complex and time-/energy-consuming and therefore not scalable. In this study, a wrapping structure is created by using a simple, rapid, and scalable "modified reprecipitation method". Graphene oxide (GO) and SiMP dispersion in tetrahydrofuran is injected into n-hexane, in which GO and SiMP by themselves cannot disperse. GO and SiMP therefore aggregate and precipitate immediately after injection to form a wrapping structure. The resulting SiMP/GO film is laser scribed to reduce GO to a laser-scribed graphene (LSG). Simultaneously, SiOx and SiC protection layers form on the SiMPs through the laser process, which alleviates severe volume change. Owing to these desirable characteristics, the modified reprecipitation method successfully doubles the cycle life of SiMP/graphene composites compared to the simple physically mixing method (50.2% vs. 24.0% retention at the 100th cycle). The modified reprecipitation method opens a new synthetic strategy for SiMP/carbon composites.

Mechanically strong micro-nano fibrillated cellulose paper with improved barrier and water-resistant properties for replacing plastic.

Replacing nonbiodegradable plastics with environmentally friendly cellulose materials has emerged as a key trend in environmental protection. This study highlights the development of a strong and hydrophobic micro-nano fibrillated cellulose paper (MNP) through the incorporation of micro-nano fibrillated cellulose fiber (MNF) and chitin nanocrystal (Ch), followed by the impregnation of polymethylsiloxane (PMHS). A low-acid, heat-assisted colloidal grinding strategy was employed to prepare MNF with a high aspect ratio effectively. Ch was incorporated as a reinforcing matrix into the cellulose fiber scaffold through straightforward mechanical mixing and mechanical hot-pressing treatments. Compared to pure MNP, the 5Ch-MNP exhibited a 25 % improvement in tensile strength, reaching 170 MPa, and showed enhanced barrier properties against oxygen and water vapor. The impregnation of PMHS rapidly confers environmentally resistant hydrophobic properties to 1 % PMHS-5Ch-MNP, leading to a water contact angle exceeding 112°, and a 290 % increase in tensile strength under wet conditions. Additionally, the paper demonstrated excellent antibacterial adhesion properties, with the adhesion rates for E. coli and S. aureus exceeding 98 %. This study successfully produced functional cellulose paper with remarkable mechanical properties and barrier properties, as well as hydrophobicity, using a simple, efficient, and environmentally friendly method, making it a promising substitute for petroleum-based plastics.

A Rapid, Scalable Laser-Scribing Process to Prepare Si/Graphene Composites for Lithium-Ion Batteries.

Silicon has gained significant attention as a lithium-ion battery anode material due to its high theoretical capacity compared to conventional graphite. Unfortunately, silicon anodes suffer from poor cycling performance caused by their extreme volume change during lithiation and de-lithiation. Compositing silicon particles with 2D carbon materials, such as graphene, can help mitigate this problem. However, an unaddressed challenge remains: a simple, inexpensive synthesis of Si/graphene composites. Here, a one-step laser-scribing method is proposed as a straightforward, rapid (≈3 min), scalable, and less-energy-consuming (≈5 W for a few minutes under air) process to prepare Si/laser-scribed graphene (LSG) composites. In this research, two types of Si particles, Si nanoparticles (SiNPs) and Si microparticles (SiMPs), are used. The rate performance is improved after laser scribing: SiNP/LSG retains 827.6 mAh g-1 at 2.0 A gSi+C -1 , while SiNP/GO (before laser scribing) retains only 463.8 mAh g-1 . This can be attributed to the fast ion transport within the well-exfoliated 3D graphene network formed by laser scribing. The cyclability is also improved: SiNP/LSG retains 88.3% capacity after 100 cycles at 2.0 A gSi+C -1 , while SiNP/GO retains only 57.0%. The same trend is found for SiMPs: the SiMP/LSG shows better rate and cycling performance than SiMP/GO composites.

Distinct changes to pancreatic volume rather than pancreatic autoantibody positivity: insights into immune checkpoint inhibitors induced diabetes mellitus.

BACKGROUND: Immune checkpoint inhibitors (ICI) are promising treatment options for various cancers. However, their use is associated with immune-related adverse events (irAEs), including ICI-induced diabetes mellitus (ICI-DM). This study aimed to investigate the clinical features of ICI-DM, with a particular focus on alterations to pancreatic volume. METHODS: We conducted a retrospective review of 2829 patients who received ICI treatment at the Chang Gung Memorial Hospital, Linkou, between January 2014 and December 2021. New-onset diabetes or diabetic ketoacidosis (DKA) was identified in ten patients receiving ICI therapy. Pancreatic volumes were assessed by manual segmentation of computed tomography (CT) images before and after ICI-DM diagnosis. RESULTS: Among these ten patients, nivolumab was the most commonly used ICI (50.0%), followed by pembrolizumab (30.0%) and atezolizumab (20.0%). One patient received combination therapy with nivolumab and ipilimumab. The median age was 63.01 years (range: 40.1 - 87.8). ICI-DM developed after a median of 13.5 cycles (range: 2 - 42) of ICI treatment or 9.85 months (range:1.5 - 21.3) since ICI initiation. The initial presentation was DKA in 60.0% of patients. All patients had low or undetectable C-peptide levels (range: <0.033 - 0.133 nmol/L) and were negative for most type 1 diabetes mellitus (T1DM)-related autoantibodies; only one patient tested positive for glutamic acid decarboxylase antibodies. CT imaging revealed significant pancreatic atrophy, with a median pancreatic volume decrease of 19.92% (P = 0.038) from baseline and sustained significant decline at last follow-up (median - 37.14%, P = 0.012). CONCLUSIONS: ICI-DM is often accompanied by pancreatic atrophy and approximately two-thirds of patients initially present with DKA. Although the majority of ICI-DM patients lack T1DM-related autoantibodies, identifying diminished pancreatic volumes through CT imaging provides valuable clues into the subclinical aspects of ICI-DM development, aiding in the prevention of diabetic emergencies. TRIAL REGISTRATION: Not applicable.

Understanding the Degradation Mechanisms of Conducting Polymer Supercapacitors.

Conducting polymers like polyaniline (PANI) are promising pseudocapacitive electrode materials, yet experience instability in cycling performance. Since polymers often degrade into oligomers, short chain length anilines have been developed to improve the cycling stability of PANI-based supercapacitors. However, the capacitance degradation mechanisms of aniline oligomer-based materials have not been systematically investigated and are little understood. Herein, two composite electrodes based on aniline trimers (AT) and carbon nanotubes (CNTs) are studied as model systems and evaluated at both pre-cycling and post-cycling states through physicochemical and electrochemical characterizations. The favorable effect of covalent bonding between AT and CNTs is confirmed to enhance cycling stability by preventing the detachment of aniline trimer and preserving the electrode microstructure throughout the charge/discharge cycling process. In addition, higher porosity has a positive effect on electron/ion transfer and the adaptation to volumetric changes, resulting in higher conductivity and extended cycle life. This work provides insights into the mechanism of enhanced cycling stability of aniline oligomers, indicating design features for aniline oligomer electrode materials to improve their electrochemical performance.

Are current wound classifications valid for predicting prognosis in people treated for limb-threatening diabetic foot ulcers?

This study aims to investigate whether the current wound classifications were valid for the treatment prognosis of subjects treated for limb-threatening diabetic foot ulcers (LTDFU). A total of 1548 patients with LTDFU and infection were studied, with wounds recorded using the Wagner, Texas, PEDIS and WIfI classifications while major lower extremity amputations (LEAs) or in-hospital mortality incidences were defined as poor outcomes. Among them, 153 (9.9%) patients received major LEAs and 38 (2.5%) patients died. After adjustments, the Wagner classification and Texas stage as well as clinical factors such as comorbidity with major adverse cardiac events (MACE), being under dialysis and having serum levels of C-reactive protein (CRP) and albumin were independent factors for prognosis. For patients without dialysis, Wagner and Texas stage stood out independently for prognosis. For patients on dialysis, only levels of CRP (odds ratio [OR] = 2.2 in Wagner, OR = 2.0 in WIfI, OR = 2.2 in Texas, OR = 2.3 in PEDIS) and albumin (OR = 0.4 in four classifications) were valid predictors. The Wagner system and Texas stage were valid for predicting prognosis in treatment for LTDFUs, suggesting a role of vascular perfusion. MACE history, levels of CRP and albumin level should assist in prediction; more significantly, only levels of CRP and albumin appeared valid for those subjects undergoing dialysis.

Microbiome of limb-threatening diabetic foot ulcers indicates the association of fastidious Stenotrophomonas and major amputation.

BACKGROUND: Proper identification of the polymicrobial microorganisms in patients with limb-threatening diabetic foot ulcers (LTDFUs) using conventional culture is insufficient. This prospective study evaluates the potential value of adjuvant molecular testing assisting in identify fastidious micro-organisms in LTDFUs compared to standard treatment alone. METHODS: Ninety patients with LTDFUs received interdisciplinary and standard antibiotic treatment in a referral diabetic foot center. A simultaneous 16S amplicon sequencing (16S AS) specimen along with conventional culture collected at admission was used to retrospectively evaluate the microbiological findings and its association with amputation outcomes. RESULTS: The microorganism count revealed by 16S AS overwhelmed that of conventional culturing (17 vs. 3 bacteria/ulcer respectively). The Stenotrophomonas spp. revealed in 29 patients were highly correlated with major (above ankle) amputation (OR: 4.76, 95% CI 1.01-22.56), while only one had been concomitantly identified by conventional culturing. Thus, there were 27 cases without proper antibiotics coverage during treatment. CONCLUSIONS: Adjuvant molecular testing assisted identification of fastidious pathogens such as Stenotrophomonas infection and might be associated with major amputation in patients with LTDFUs.

Exciton dynamics of an aggregation-induced delayed fluorescence emitter in non-doped OLEDs and its application as host for high-efficiency red phosphorescent OLEDs.

Aggregation-induced delayed fluorescence (AIDF) materials have great potential in non-doped OLEDs due to their high photoluminescence (PL) quantum efficiency in film, high exciton utilization in the aggregated state and negligible efficiency roll-off at high luminance. However, their efficient mechanism in OLEDs is not yet well understood. Here, the exciton dynamics are used to investigate the electroluminescence (EL) mechanism of an AIDF emitter (4-(10H-phenoxazin-10-yl)phenyl)-(9-phenyl-9H-carbazol-3-yl)methanone (CP-BP-PXZ) in detail. It can be seen that the high efficiency and negligible efficiency roll-off in non-doped OLEDs based on CP-BP-PXZ as the emitter are ascribed to the effective reverse intersystem crossing (RISC) from high level triplet T2 to singlet S1 in the aggregated state. Furthermore, CP-BP-PXZ also exhibits excellent properties as a phosphor host due to its good AIDF properties. Thus, high-efficiency red phosphorescent OLEDs with low roll-off efficiency are successfully fabricated based on CP-BP-PXZ as the host. The maximum external quantum efficiency (EQEmax) reaches 23% and is maintained at 21% at a luminance of 1000 cd m-2.

Downregulation of TAZ elicits a mitochondrial redox imbalance and ferroptosis in lung epithelial cells exposed to diesel exhaust particles.

Mitochondrial dysfunction was reported to be involved in the development of lung diseases including chronic obstructive pulmonary disease (COPD). However, molecular regulation underlying metabolic disorders in the airway epithelia exposed to air pollution remains unclear. In the present study, lung bronchial epithelial BEAS-2B and alveolar epithelial A549 cells were treated with diesel exhaust particles (DEPs), the primary representative of ambient particle matter. This treatment elicited cell death accompanied by induction of lipid reactive oxygen species (ROS) production and ferroptosis. Lipidomics analyses revealed that DEPs increased glycerophospholipid contents. Accordingly, DEPs upregulated expression of the electron transport chain (ETC) complex and induced mitochondrial ROS production. Mechanistically, DEP exposure downregulated the Hippo transducer transcriptional co-activator with PDZ-binding motif (TAZ), which was further identified to be crucial for the ferroptosis-associated antioxidant system, including glutathione peroxidase 4 (GPX4), the glutamate-cysteine ligase catalytic subunit (GCLC), and glutathione-disulfide reductase (GSR). Moreover, immunohistochemistry confirmed downregulation of GPX4 and upregulation of lipid peroxidation in the bronchial epithelium of COPD patients and Sprague-Dawley rats exposed to air pollution. Finally, proteomics analyses confirmed alterations of ETC-related proteins in bronchoalveolar lavage from COPD patients compared to healthy subjects. Together, our study discovered that involvement of mitochondrial redox dysregulation plays a vital role in pulmonary epithelial cell destruction after exposure to air pollution.

A Low-Cost, Sensitive Reporter System Using Membrane-Tethered Horseradish Peroxidase for Efficient Gene Expression Analysis.

Reporter gene assays are essential for high-throughput analysis, such as drug screening or determining downstream signaling activation/inhibition. However, use of this technology has been hampered by the high cost of the substrate (e.g., d-Luciferin (d-Luc)) in the most common firefly luciferase (FLuc) reporter gene assay. Although alternate luciferase is available worldwide, its substrate has remained expensive, and a more affordable option is still in demand. Here, we present a membrane-tethered horseradish peroxidase (mHRP), a new reporter system composed of a cell membrane expressing HRP that can preserve its enzymatic function on the cell surface, facilitates contact with HRP substrates (e.g., ABTS and TMB), and avoids the cell lysis process and the use of the high-priced luciferase substrate. An evaluation of the light signal sensitivity of mHRP compared to FLuc showed that both had comparable signal sensitivity. We also identified an extended substrate half-life of more than 5-fold that of d-Luc. Of note, this strategy provided a more stable detection signal, and the cell lysis process is not mandatory. Furthermore, with this strategy, we decreased the total amount of time taken for analysis and increased the time of detection limit of the reporter assay. Pricing analysis showed a one-third to one twenty-eighth price drop per single test of reporter assay. Given the convenience and stability of the mHRP reporter system, we believe that our strategy is suitable for use as an alternative to the luciferase reporter assay.

Non-Doped Blue AIEgen-Based OLED with EQE Approaching 10.3 .

Aggregation-induced emission (AIE) luminogens (AIEgens) are attractive for the construction of non-doped blue organic light-emitting diodes (OLEDs) owning to their high emission efficiency in the film state. However, the large internal inversion rate (kIC (Tn) ) between high-lying triplet levels (Tn ) and Tn-1 causes a huge loss of triplet excitons, resulting in dissatisfied device performance of these AIEgens-based non-doped OLEDs. Herein, we designed and synthesized a blue luminogen of DPDPB-AC by fusing an AIEgen of TPB-AC and a DMPPP, which feature hot exciton and triplet-triplet annihilation (TTA) up-conversion process, respectively. DPDPB-AC successfully inherits the AIE feature and excellent horizontal dipole orientation of TPB-AC. Furthermore, it owes smaller kIC (Tn) than TPB-AC. When DPDPB-AC was applied in OLED as non-doped emitting layer, an outstanding external quantum efficiency of 10.3 % and an exceptional brightness of 69311 cd m-2 were achieved. The transient electroluminescent measurements and steady-state dynamic analysis confirm that both TTA and hot exciton processes contribute to such excellent device performance. This work provides a new insight into the design of efficient organic fluorophores by managing high-lying triplet excitons.

A study of glycemic perturbations following two doses of COVID-19 vaccination for patients with diabetes: the impacts of vaccine type and anti-diabetes drugs.

BACKGROUND: Glycemic monitoring has become critical during the COVID-19 pandemic because of poor prognosis in diabetes. Vaccines were key in reducing the spread of infection and disease severity but data were lacking on effects on blood sugar levels. The aim of the current study was to investigate the impact of COVID-19 vaccination on glycemic control. METHODS: We performed a retrospective study of 455 consecutive patients with diabetes who completed two doses of COVID-19 vaccination and attended a single medical center. Laboratory measurements of metabolic values were assessed before and after vaccination, while the type of vaccine and administrated anti-diabetes drugs were analyzed to find independent risks associated with elevated glycemic levels. RESULTS: One hundred and fifty-nine subjects received ChAdOx1 (ChAd) vaccines, 229 received Moderna vaccines, and 67 received Pfizer-BioNtech (BNT) vaccines. The average HbA1c was raised in the BNT group from 7.09 to 7.34% (P = 0.012) and non-significantly raised in ChAd (7.13 to 7.18%, P = 0.279) and Moderna (7.19 to 7.27%, P = 0.196) groups. Both Moderna and BNT groups had around 60% of patients with elevated HbA1c following two doses of COVID-19 vaccination, and the ChAd group had only 49%. Under logistic regression modeling, the Moderna vaccine was found to independently predict the elevation of HbA1c (Odds ratio 1.737, 95% Confidence interval 1.12-2.693, P = 0.014), and sodium-glucose co-transporter 2 inhibitor (SGLT2i) was negatively associated with elevated HbA1c (OR 0.535, 95% CI 0.309-0.927, P = 0.026). CONCLUSIONS: Patients with diabetes might have mild glycemic perturbations following two doses of COVID-19 vaccines, particularly with mRNA vaccines. SGLT2i showed some protective effect on glycemic stability. Hesitancy in having vaccinations should not be indicated for diabetic patients with respect to manageable glycemic change. TRIAL REGISTRATION: Not applicable.

Molecular Engineering of Hierarchical Conducting Polymer Composites for Highly Stable Supercapacitors.

Long cycle life and high energy/power density are imperative to energy storage systems. Polyaniline (PANI) has shown great potential as an electrode material but is limited by poor cycling and rate performance. We present a molecular design approach of binding short-chain aniline trimers (ATs) and carbon nanotubes (CNTs) through the formation of amide covalent linkages enabled by a simple laser scribing technique. The covalently coupled AT/CNT (cc-AT/CNT) composite retains 80% of its original capacitance after 20 000 charge/discharge cycles, which readily outperforms long-chain PANI/CNT composites without covalent connections. The compact AT/CNT heterointerfaces produce fast charge/discharge kinetics and excellent rate capability. The flexible symmetric quasi-solid-state devices can be stably cycled beyond 50 000 cycles, at least 5 times longer than most PANI/CNT-based symmetric supercapacitors reported to date. This molecular design of durable conducting polymer-based electrode materials enabled by laser irradiation presents a feasible approach toward robust advanced energy storage devices.

Increasing the operating lifetime of green phosphorescent organic light emitting diodes by reducing charge accumulation at the interface.

The stability and degradation mechanism of phosphorescent organic light emitting diodes (OLEDs) has been an unresolved problem in the past decades. Here, we found that electron accumulation at the interface between the electron blocking layer and the emitting layer is one of the reasons for device degradation. By inserting a thin layer with a shallower LUMO level than that of the electron transporting layer between the emitting layer and the electron transporting layer, we successfully reduced the density of electrons at the interface and greatly improved the lifetime of the resulting green phosphorescent OLEDs. The half decay lifetime LT50 at the initial luminance of 1000 cd m-2 reached as high as 399 h, which is 1.7 times longer than that of the compared device without a thin layer.

Obesity-mediated upregulation of the YAP/IL33 signaling axis promotes aggressiveness and induces an immunosuppressive tumor microenvironment in breast cancer.

Obesity is a well-known risk factor for breast cancer formation and is associated with elevated mortality and a poor prognosis. An obesity-mediated inflammatory microenvironment is conducive to the malignant progression of tumors. However, the detailed molecular mechanism is still needed to be clarified. Herein, we identified that breast cancer cells from mice with diet-induced obesity exhibited increased growth, invasiveness, and stemness capacities. A transcriptome analysis revealed that expressions of interleukin 33 (IL33) signaling pathway-related genes were elevated in obesity-associated breast cancer cells. Importantly, IL33 expression was significantly associated with the yes-associated protein (YAP) signature, and IL33 was transcriptionally regulated by YAP. Suppression of IL33 reduced tumor migration and invasion, while the addition of IL33 activated nuclear factor (NF)-κB signaling and revived tumor mobility in YAP-silenced cells. Furthermore, suppression of YAP attenuated IL33 expression which was accompanied by relief of obesity-mediated immunosuppression. Clinical analyses showed that IL33 expression was markedly associated with macrophage and regulatory T cell infiltration. These findings reveal a crucial role of the YAP/IL33 axis in promoting aggressiveness and immunosuppression of obesity-associated breast cancer progression.

Short-term effects and economic burden of air pollutants on acute lower respiratory tract infections in children in Southwest China: a time-series study.

BACKGROUND: There are few studies on the effects of air pollutants on acute lower respiratory tract infections (ALRI) in children. Here, we investigated the relationship of fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), and nitrogen dioxide (NO2) with the daily number of hospitalizations for ALRI in children in Sichuan Province, China, and to estimate the economic burden of disease due to exposure to air pollutants. METHODS: We collected records of 192,079 cases of childhood ALRI hospitalization between January 1, 2017 and December 31, 2018 from nine municipal/prefecture medical institutions as well as the simultaneous meteorological and air pollution data from 183 monitoring sites in Sichuan Province. A time series-generalized additive model was used to analyze exposure responses and lagged effects while assessing the economic burden caused by air pollutant exposure after controlling for long-term trends, seasonality, day of the week, and meteorological factors. RESULTS: Our single-pollutant model shows that for each 10 µg/m3 increase in air pollutant concentration (1 µg/m3 for SO2), the effect estimates of PM2.5, PM10, SO2, and NO2 for pneumonia reached their maximum at lag4, lag010, lag010, and lag07, respectively, with relative risk (RR) values of 1.0064 (95% CI, 1.0004-1.0124), 1.0168(95% CI 1.0089-1.0248), 1.0278 (95% CI 1.0157-1.0400), and 1.0378 (95% CI, 1.0072-1.0692). By contrast, the effect estimates of PM2.5, PM10, SO2, and NO2 for bronchitis all reached their maximum at lag010, with RRs of 1.0133 (95% CI 1.0025-1.0242), 1.0161(95% CI 1.0085-1.0238), 1.0135 (95% CI 1.0025-1.0247), and 1.1133(95% CI 1.0739-1.1541). In addition, children aged 5-14 years were more vulnerable to air pollutants than those aged 0-4 years (p < 0.05). According to the World Health Organization's air quality guidelines, the number of ALRI hospitalizations attributed to PM2.5, PM10, and NO2 pollution during the study period was 7551, 10,151, and 7575, respectively, while the incurring economic burden was CNY 2847.06, 3827.27, and 2855.91 million. CONCLUSION: This study shows that in Sichuan Province, elevated daily average concentrations of four air pollutants lead to increases in numbers of childhood ALRI hospitalizations and cause a serious economic burden.

Attributable risk and economic burden of pneumonia among older adults admitted to hospital due to short-term exposure to airborne particulate matter: a time-stratified case-crossover study from China.

Many studies have proven the relationship between air pollutants and respiratory diseases, but few studies have assessed the impacts of air particulate matter exposure on older patients with pneumonia. This study aimed to reveal the impacts of short-term exposure to air particulate matter on the daily number of older adult patients hospitalized due to pneumonia and calculate the economic costs attributable to this exposure. We collected inpatient data from 9 city hospitals in Sichuan Province, China, from January 1, 2018, to December 31, 2019, and calculated odds ratios and 95% confidence intervals using a time-stratified case-crossover study design and an attributable risk model to calculate the economic burden due to particulate matter pollution. It was found that for every 10 µg/m3 increase in PM2.5 and PM10 concentrations, the daily number of older adult pneumonia inpatients increased by 1.5% (95% CI: 1.010-1.021) and 1.0% (95% CI: 1.006-1.014), respectively. Those 65 ~ 79 years old were more susceptible to air particulate pollutants (P < 0.05). During the study period, the total hospitalization costs and out-of-pocket expenses attributable to PM2.5 and PM10 exposure were 44.60 million CNY (6.22%) and 16.03 million CNY (6.21%), respectively, with PM2.5 being the primary influencing factor. This study revealed the relationship between particulate matter pollution and pneumonia among older adults. The role of policies to limit particulate matter concentrations in reducing disease burden among older adults can be further explored.